Chinese General Practice ›› 2022, Vol. 25 ›› Issue (16): 2014-2020.DOI: 10.12114/j.issn.1007-9572.2022.0143

Special Issue: 阿尔茨海默病最新文章合集 精神卫生最新文章合集

• Original Research·Primary Care Health Services • Previous Articles     Next Articles

Beijing's Mental Health Workers' Perceptions of the Severe Mental Illness Reporting System

  

  1. 1.School of Medical Humanities, Capital Medical University, Beijing 100069, China
    2.School of Public Health, Capital Medical University, Beijing 100069, China
  • Received:2021-11-04 Revised:2022-03-17 Published:2022-06-05 Online:2022-04-28
  • Contact: Xiaoyong LI
  • About author:
    WANG H M, LI X Y, ZHANG N, et al. Beijing's mental health workers' perceptions of the Severe Mental Illness Reporting System[J]. Chinese General Practice, 2022, 25 (16) : 2014-2020.

北京市精神卫生医务人员对严重精神障碍发病报告制度的认知研究

  

  1. 1.100069 北京市,首都医科大学医学人文学院
    2.100069 北京市,首都医科大学公共卫生学院
  • 通讯作者: 李筱永
  • 作者简介:
    王昊旻,李筱永,张柠,等.北京市精神卫生医务人员对严重精神障碍发病报告制度的认知研究[J].中国全科医学,2022,25(16):2014-2020. [www.chinagp.net] 作者贡献:王昊旻进行文章的构思与设计、研究的实施与可行性分析、数据收集与整理、论文撰写;王昊旻、吴佼玥进行统计学处理;王昊旻、张柠进行结果的分析与解释;王昊旻、李筱永进行论文的修订、文章的质量控制及审校;李筱永对文章整体负责,监督管理。
  • 基金资助:
    北京市社会科学基金重点项目--风险预警背景下北京市严重精神障碍发病报告制度研究(18FXA001)

Abstract:

Background

The Severe Mental Illness Reporting System (SMIRS) has been operated for many years as an important part of mental health monitoring, but its effectiveness needs to be further explored.

Objective

To analyze the perceptions of mental health workersfrom municipal-, district- and community-level hospitals in Beijing regarding the importance, main role, effects and problems during the implementation, and improvement measures concerning the SMIRS, providing suggestions facilitating the improvement of the system.

Methods

From March to June 2019, a survey was conducted among a convenient sample of 234 mental health workers from municipal-level psychiatric hospitals, and two stratified samples of 397 mental health workers (one sample of 183 cases from district-level psychiatric hospitals, and the other sample of 214 cases from community-level hospitals) , using a questionnaire named Status of the Rule of Mental Health Laws in Beijing for understanding these workers' general information and their perceptions of the SMIRS.

Results

The SMIRS was assessed as "very important" by 56.3% (103/183) of the mental health workers from district-level hospitals and 54.7% (117/214) of those from community-level hospitals, and as "relatively important" by 66.7% (156/234) of those from municipal-level hospitals.The major role of the SMIRS was assessed as "risk warnings for mental illnesses" by 76.9% (180/234) of the mental health workers from municipal-level hospitals and 82.7% (177/214) of those from community-level hospitals, and as facilitating community-based management of mental illnesses by 80.9% (148/183) of those from district-level hospitals. The implementation effectiveness of the SMIRS was evaluated as "relatively good" by 44.4% (104/234) of mental health workers from municipal-level hospitals, 50.3% (92/183) of those from district-level hospitals, and 50.9% (109/214) of those from community-level hospitals. And the number of workers choosing "relatively good" accounted for the highest percentage of the total workers from each kind of hospitals. The major problem during the implementation of the SMIRS was assessed as "involving patient privacy" by 77.8% (182/234) of the mental health workers from municipal-level hospitals, 78.1% (143/183) of those from district-level hospitals, and 83.2% (178/214) of those from community-level hospitals. And the number of workers choosing "involving patient privacy" accounted for the highest percentage of the total workers from each kind of hospitals. "Standardizing the system of information entry, registration, correction, and summary" was chosen as a measure for improving the implementation of the SMIRS by 73.5% (172/234) of the mental health workers from municipal-level hospitals, and 76.6% (164/214) of those from community-level hospitals, while "standardizing the system of information sharing and protection of patients' privacy" was chosen by 68.9% (126/183) of those from district-level hospitals.

Conclusion

The role and implementation effectiveness of the SMIRS have won the approval of mental health workers from municipal-, district- and community-level hospitals. To further improve the implementation of SMIRS with a dual emphasis on risk containment and privacy protection and consideration for patient management services, we put forward the following recommendations: detailing relevant legal provisions; insisting on ensuring patients access to relevant services (including management) , improving the mental health service system, and implementing the essential and major public health service programs; increasing policy publicity to improve the recognition of the system by patients and their families.

Key words: Mental disorders, severe, Medical staff, Severe Mental Illness Reporting System, Beijing

摘要:

背景

严重精神障碍发病报告制度作为精神卫生监测的重要一环已运行实施多年,实施效果需要进一步探知。

目的

分析北京市三类精神卫生医务人员对严重精神障碍发病报告制度重要性、主要作用、实施效果、存在问题及完善措施的认知,为促进该制度的完善提供建议。

方法

2019年3—6月,采用方便抽样方法选择234例市级精神专科医院医务人员,采用分层抽样方法选择183例区级精神专科医院医务人员,采用分层抽样方法选择214例社区精神卫生防治医务人员作为研究对象,采用"北京市精神卫生法治状况调查问卷"进行问卷调查,问卷主要内容包括医务人员基本信息及对严重精神障碍发病报告制度的认知。

结果

对于制度重要性,56.3%(103/183)的区级精神专科医院和54.7%(117/214)的社区精神卫生防治医务人员认为其"非常重要",66.7%(156/234)的市级精神专科医院医务人员认为其"比较重要"。对于主要作用,76.9%(180/234)的市级精神专科医院医务人员和82.7%(177/214)的社区精神卫生防治医务人员认为该制度主要作用为"风险预警",80.9%(148/183)的区级精神专科医院医务人员认为该制度主要作用为"社区管理"。对于实施效果,44.4%(104/234)的市级精神专科医院医务人员、50.3%(92/183)的区级精神专科医院医务人员和50.9%(109/214)的社区精神卫生防治医务人员认为严重精神障碍发病报告制度实施效果比较好。对于存在问题,77.8%(182/234)的市级精神专科医院医务人员、78.1%(143/183)的区级精神专科医院医务人员和83.2%(178/214)的社区精神卫生防治医务人员认为该制度主要存在的问题为"报告涉及患者隐私信息的收集"。对于完善措施,73.5%(172/234)的市级精神专科医院医务人员和76.6%(164/214)的社区精神卫生防治医务人员认为严重精神障碍发病报告制度完善措施为"规范信息录入、登记、更正、汇总制度",68.9%(126/183)的区级精神专科医院医务人员认为制度完善措施为"规范信息共享及对患者隐私保护的制度"。

结论

三类医务人员对严重精神障碍发病报告制度的作用及实施效果表示肯定,为实现风险防控与隐私保护并重,兼顾患者管理与服务,应当对该制度予以完善,包括:在法律层面细化相关规定;对患者坚持服务保障与管理并重,完善精神卫生服务体系,落实基本与重大公共卫生服务项目;增加政策宣传力度,提高患者及家属对该制度的认可度。

关键词: 精神障碍,严重, 医务人员, 严重精神障碍发病报告制度, 北京